Objective:

Our aim was to assess differences in medical patients with bacteraemia (B) due to multi-resistant (MR) pathogens regarding epidemiology, severity and outcome compared to ones with B pathogens of usually anticipated susceptibilities.

Patient-methods:

All medical patients admitted in a 700 bed tertiary hospital's department with signs of severe infection were entered in a PC database and only patients with documented B were proceeded to SPSS analysis. MR pathogens defined as those resistant in at least 3 antimicrobial classes. Time: May 2004 to Oct 2005.

Results:

A total of 75 patients (M:33, F:42, m.age:68.4 ± 14 yrs) were found with B. Of those MR B occurred in 17 (22.6% of Bs) due to Klebsiella sp: 5, MRSA: 4, Acinetobacter 3, Pseudomonas 2, Serratia, Salmonella, S. faecalis one each. Comparing MR B to the other bacteraemias, there were no statistical significance in previous antimicrobial use [47% v 36%] or hospitalization, comoridity, origin, SIRS criteria at admission (3 v 2.5). Appropriateness of initial regimen was, expectedly, less in MR (59% v 95%, p < 0.001) but did not correlate with higher mortality (6 v 18%, NS). The only significant difference noted was a considerably longer length of stay (27.6 v 9.8 days, p < 0.0001) in patients with.

Conclusions:

Apart from a considerable longer stay patient characteristics and outcomes did not differ significantly among patients with MR B, though, obviously, a greater number may achieve this, as documented in MR literature. The main point is that seeking bacteriology documentation allows for regimen modification to allow favourable outcome in extremely difficult to treat infections.